Christopher M. Wharton

Examining the Nutritional Quality of Breakfast Cereals Marketed to Children

There are both public health and food industry initiatives aimed at increasing breakfast consumption among children, particularly the consumption of ready-to-eat cereals. The purpose of this study was to determine whether there were identifiable differences in nutritional quality between cereals that are primarily marketed to children and cereals that are not marketed to children. Of the 161 cereals identified between January and February 2006, 46% were classified as being marketed to children (eg, packaging contained a licensed character or contained an activity directed at children). Multivariate analyses of variance were used to compare childrens cereals and nonchildrens cereals with respect to their nutritional content, focusing on nutrients required to be reported on the Nutrition Facts panel (including energy). Compared to nonchildrens cereals, childrens cereals were denser in energy, sugar, and sodium, but were less dense in fiber and protein. The proportion of childrens and nonchildrens cereals that did and did not meet national nutritional guidelines for foods served in schools were compared using chi2analysis. The majority of childrens cereals (66%) failed to meet national nutrition standards, particularly with respect to sugar content. t tests were used to compare the nutritional quality of childrens cereals with nutrient-content claims and health claims to those without such claims. Although the specific claims were generally justified by the nutritional content of the product, there were few differences with respect to the overall nutrition profile. Overall, there were important differences in nutritional quality between childrens cereals and nonchildrens cereals. Dietary advice for children to increase consumption of ready-to-eat breakfast cereals should identify and recommend those cereals with the best nutrient profiles.

Changing Nutrition Standards in Schools: The Emerging Impact on School Revenue

BACKGROUND Although great focus has been placed on nutritional and other consequences of changes in food-related policies within schools, few reports exist describing the impact of such changes on school revenue. This review provides an overview of the few revenue-related studies published recently, as well as information from a sampling of state reports on the subject. METHODS A systematic review of the literature was conducted. Four peer-reviewed papers and 3 state-based reports were identified that assessed the impact on revenues of either targeted policy changes or overarching, district-wide changes in food-related policies. RESULTS Thus far, few data exist to substantiate the concern that changes in nutrition standards in schools lead to a loss in total revenue. An interesting phenomenon of increased participation in the National School Lunch Program was noted in a number of reports and might play a role in buffering financial losses. CONCLUSIONS A renewed focus on school policies related to health provides the opportunity for researchers to investigate how nutrition-related policy change can affect, if at all, food service and overall school revenues.

Strength and Comprehensiveness of District School Wellness Policies Predict Policy Implementation at the School Level

BACKGROUND In 2006, all local education agencies in the United States participating in federal school meal programs were required to establish school wellness policies. This study documented the strength and comprehensiveness of 1 states written district policies using a coding tool, and tested whether these traits predicted school-level implementation and practices. METHODS School wellness policies from 151 Connecticut districts were evaluated. School principal surveys were collected before and after the writing and expected implementation of wellness policies. Sociodemographic variables were assessed for each district, including enrollment, population density, political climate, racial composition, and socioeconomic status. Changes in school-level policy implementation before and after the federal wellness policy mandate were compared across districts by wellness policy strength; policies were compared based on district-level demographics. RESULTS Statewide, more complete implementation of nutrition and physical activity policies at the school level was reported after adoption of written policies. Districts with stronger, more comprehensive policies were more successful in implementing them at the school level. Some sociodemographic characteristics predicted the strength of wellness policies. CONCLUSIONS Written school wellness policies have the potential to promote significant improvements in the school environment. Future regulation of school wellness policies should focus on the importance of writing strong and comprehensive policies.

Community supported agriculture membership in Arizona. An exploratory study of food and sustainability behaviours

Community supported agriculture (CSA) programs have become a viable source of locally produced foods and represent a new way to increase fruit and vegetable consumption among individuals. Because CSAs represent a way for consumers to acquire healthy foods while providing financial support to local farmers, CSA involvement could reflect, and be related to, greater concern with both health and environmental impact of food choice. As such, the aim of this study was to examine whether ecological attitudes of CSA members could predict food- and sustainability-related behaviours. Using an online survey, respondents answered questions about attitudes towards the environment, as well behaviours related to food purchases, family food preparation, composting, recycling and minimising food-packaging waste. A total of 115 CSA member responses were collected. Ordinary least squares (OLS) multivariate regression analysis was used to investigate the predictive validity of environmental attitudes on measures of behaviours. A large portion of participants reported the amount and variety of fruits and vegetables their households ate increased as a result of joining a CSA program. Ecological sensitivity was a significant predictor of sustainability-related behaviours as well as money spent eating out and times eaten away from home per week. However, it was not predictive of family involvement in home food preparation.

University Engagement Through Local Food Enterprise: Community-Supported Agriculture on Campus

Community-supported agriculture programs (CSAs) are growing in number and variety across the country. Though CSAs can be found in a variety of settings, a less common but potentially successful venue in which to run a CSA is the university campus. Although universities present certain challenges for operating a CSA, they offer a number of unique advantages that can aid in the growth and success of the campus CSA. As such, university-based food and nutrition professionals may find that CSA development is a viable avenue through which to accomplish nutrition goals, such as increasing consumption of fresh fruits and vegetables. In this article, the authors review both the benefits and detriments of operating a CSA on a university campus and present 2 different but successful university CSA models.

Community Supported Agriculture Programs: A Novel Venue for Theory-Based Health Behavior Change Interventions

Local foods programs such as community supported agriculture programs (CSAs) and farmers’ markets have increased greatly in popularity. However, little research has been conducted regarding the effect of involvement in local foods programs on diet-related attitudes and behaviors. A series of focus groups was conducted to identify the motives that propel individuals to join a CSA, the experiences of belonging to a CSA, and the diet-related outcomes of CSA membership. Using the Theory of Planned Behavior (TPB) as a framework to categorize findings, data suggest the potential of CSAs as a viable intervention strategy for promoting healthful diets and behaviors.

Women, Infants, and Children Cash Value Voucher (CVV) Use in Arizona: A Qualitative Exploration of Barriers and Strategies Related to Fruit and Vegetable Purchases

OBJECTIVE Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them. DESIGN Eight focus groups were conducted to explore attitudes and behaviors related to CVV use. SETTING Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ. PARTICIPANTS Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households. PHENOMENON OF INTEREST Perceived barriers to CVV use and strategies used to maximize their purchasing value. ANALYSIS Transcripts were analyzed using a general inductive approach to identify emergent themes. RESULTS Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power. CONCLUSIONS AND IMPLICATIONS Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences.

Weight bias: A primer for the fitness industry

Learning Objective To increase awareness among fitness professionals about weight bias and its consequences, and to outline strategies for increasing sensitivity and preventing bias with overweight and obese populations.

Assessing implementation of evidence-based childhood obesity prevention strategies in schools

Objective Research suggests that schools can play a key role in obesity prevention by implementing evidence-based strategies promoting student health. This study explores school climate factors underlying implementation of evidence-based health and wellness policies and practices in Kindergarten–8th grade programs in the Southwestern United States. Method Utilizing a participatory research survey approach conducted in December 2011 with school health professionals (N = 62) and a multiple regression design, a moderated predictive model of implementation climate (i.e., attitudes and beliefs about prevention, school commitment to prevention, barriers, and stakeholder collaboration) was tested. Results Barriers to obesity prevention efforts, such as lack of resources, support, or strategy clarity, hinder implementation of healthy food policies despite strong school commitment to prevention. Along with the commitment to prevention, stakeholder collaboration predicts physical education strategies, specifically reducing restricted access to physical education as a punishment for student misconduct. Conclusion Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place.

Healthy store programs and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but not the Supplemental Nutrition Assistance Program (SNAP), are associated with corner store healthfulness

In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agricultures Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores. Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments. Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65–3.71; non-upgraded: M = 2.52, 95% CI 2.32–2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6–14.1; non-upgraded: M = 12.5, 95% CI 12.0–13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores. WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.